Nasal congestion is simply nasal mucus that
is partially obstruction the nasal passages. Nasal congestion is not a runny nose but
rather is a stuffy nose. A stuffy nose will sound "stuffy" or nasally, but will
not be runny.

Nasal mucus is produced to moisten the air entering the
lungs to prevent drying out the lungs. Nasal mucus is also produced in response to a nasal
irritation such as with cigarette smoke, hair spray, perfume, house dust, stove smoke
(wood and coal) or when someone suctions the nose too vigorously. When the child can't
remove the dried secretions on their own, then the mucus will partially obstruct the
airway and the parents will hear congestion.

Nasal congestion is almost universal among infants below
6 months of age and among all of us in the winter. Even without treatment, most congestion
will subside about 4 to 6 months of age. Some children will have abnormally small nasal
passages, allergies or continued exposure to irritants and the symptoms could continue
indefinitely.

First, try to remove the irritants
listed above that may be causing the congestion.

Second and most importantly, run a
vaporizer in the child's room. A cool mist vaporizer is much better for croup, while a
warm mist vaporizer may be slightly better for colds and a humidifier is quieter,
otherwise there is no difference in which device you use. If you don't have one yet and
money is short buy a cool mist vaporizer so you won't have to buy one later for croup.

Third, use saline nose drops to loosen
the nasal mucus. You can buy over the counter saline nose drops (Ocean spray, Ayre, Nasal,
etc.) or make your own. Make fresh saline nasal drops daily by mixing 1/4 tsp. of table
salt in a cup of water. Put a drop or two of the saline into one nostril. Leave it in a
minute while massaging the side of the nose (optional), then suction out the nose. What
you don't get out, your child will just swallow naturally. Do only one side at a time
because infants do not know how to breathe through their mouths until 4 to 6 months of
age.

Fourth, don't suction the nose too
vigorously or you will irritate the nose and cause it to produce more mucus.

Fifth, don't use the suction bulb the
hospital gave you with the long pointy end. This is actually an ear syringe and when place
too far in the nose will make the mucus worse. Try sticking a q-tip up you nose to see how
it feels and see if you get stuffy. Use instead the kind with the blunt clear screw in
piece.

Sixth, make sure to suction before
feeding and bedtime.

Seventh, do not use cold medicines or
decongestants. As appealing as they sound, they really don't help and I have seen too many
patients hit the emergency room with seizures, irritability and hallucinations from cold
medicines.

Eighth, elevate the head of the child's
bed to help the secretions drain.

Ninth and lastly, recognize that nasal
congestion is normal and will be a part of your life for the next few years. A baby that's
comfortable and resting but is congested does not have a problem until someone tries to
stick something up their nose.

Nasal congestion is fairly distinct, but some other problems can be similar:

Allergies: This gives a runny nose, not generally a stuffy one. There
often will be pinkness to the eye lids and clear runny eyes.

Choanal Atresia: The is a membrane that blocks one or both nasal
passages. A infant with both passages blocked would not get out of the hospital
undiscovered. If one of the passages was blocked, the baby would only be able to breathe
out of one nostril. You can test for this by simply blocking one nostril and listening to
see if the baby breathes out the other. This will not resolve on its own and cannot just
show up later, therefore, if your child had been able to breathe through that nostril
before then this is not the cause.

Colds: a cold gives a runny nose not a
stuffy one, but you can treat a cold the same way. Colds also give low grade fevers and a
cough, which nasal congestion never has with it.

Nasal polyp: These are quite unusual in this age range, in fact I have
never seen one in a child. This would be essentially like a choanal atresia except that it
is not present at first and grows later.

Sinus infection: This is usually a profusely runny nasal discharge
that is green and associated with a "face ache" and low grade fevers.

Nasal congestion is easy to diagnose and treat on your own. If you see
something not mentioned here or something changes, then you may want to let your physician
know:

During business hours if: the mucus become profuse and
green (green nasal mucus is a normal healing process provided it only lasts a
few days) or worsens over a couple of days, there is a low fever (<102), you have tried
all of the above without success (nothing cures it you can just make your child
comfortable for awhile), your child has moderate difficulty with eating (after you have
suctioned them out of course).